Surgical sheet



June 2, 1942. E. F. BRUNING SURGICAL SHEET Filed Dec. 24, 1958- fzy/ nn n eu r vr o m 7m a Patented June 2, 1942 UNITED STATES PATENT QFFICE 9 Claims.

This invention has to do generally with improvements in surgical apparel and appliances such as pads, drapes and the like used in surgical and obstetrical operations, and has for its major purpose to provide articles of this character made Ifrom materials or combinations of materials possessing numerous advantages over those customarily used for such purposes. Among these advantages are greater assurance that the articles will be kept in a thoroughly sterilized condition before use, adaptability for economically dispensing them in sterilized and hermetically sealed packs each comprising any predetermined number or, combination of articles, such as a complete operating outt that may be made generally available, as distinguished from the usual sterilized linens that ordinarily can be had only where sterilization facilities are provided. Further advantages have to do with the properties and qualities of the materials themselves, that render the various articles contemplated by the invention,

superior to those customarily used.

,The present application is a continuation in part of my copending application Serial Number 43,001, led October 1, 1935, in Surgical apparel and appliances.

Under conditions of use, most of the articles, and particularly pads placed beneath the patient, are subjected to wetting by considerable amounts of blood or other uids, and consequently are desirably moisture absorptive. Heretofore, the customary practice has been to make surgical garments, pads and drapes of sterilized cloth fabric which is washed and resterilized for use again after each operation. Because of the costl of the cloth articles, they are used repeatedly instead of being destroyed after use. One of my major objects is to provide surgical sheet materials that may be substituted for the usual cloth fabrics, and which will have the advantage of giving to the sheet all the necessary quality of moisture absorptiveness, and uid impermeability to a greater degree than could be had without the use of excessive amounts of cloth fabric. In addition, 'it is my purpose to provide sheet materials which, notwithstanding initial sterilization and packaging, may, because vof their low cost, be burned and destroyed after use.

The present surgical sheet differs characteristically from that commonly used in that it is made of paper, and preferably a combination of papers which together form a composite sheet possessing various properties which render it particularly suitable for this purpose. Speaking generally of the composite sheet, I employ a combination of papers in two or more layers, one of which has the combined properties of hygroscopicity and moisture permeability, without.

however, being disintegrable by moisture, at least under al1 normal conditions of use. This particular layer, which may be referred to as the outer or exposed layer, has by reason of its hygroscopic property, the ability to retain and pass moisture, so that liquids deposited on the sheet are elTectively retained and permitted to pass through the outer layer. For reasons that will later appear, it is also desirable that this outer layer be relatively pliable and soft to the touch, inasmuch as the surface normally will come in contact with the patient, at least in surgical pads and drapes.

This combination of desirable properties is best obtained by the use of a relatively thin and pliable paper which, .for example, may consist of a suitable cellulose or parchment stock that is treated to give it the necessary hygroscopicity and moisture permeability. Preferably I use a thin, smooth and very pliable glycerin-treated parchment which may be made by first producing a regular parchment, using a proper waterleaf paper of the type ordinarily employed, and treating the waterleaf with sulphuric acid to produce the parchment. As is commonly known, one elect of the parchmentizing process is to substantially destroy the fibrous character of the paper by cementing or joining the paper fibers into a homogeneous and non-fuzzy Web of cellulose, thereby rendering it capable of becoming wetted, soaked, and even boiled or sterilized without disintegrating or becoming easily split or torn. For light glycerin treatments, the glycerin may be incorporated in the parchment by any suitable known method of surface application, as by passing the parchment over or between rollers lmed with glycerin. For my purposes, however, it is desirable that the parchment be rather heavily glycerinized, and generally it may be found preferable to run the parchment paper through a glycerin bath, and then, in a separate subsequent operation, to pass the paper between squeeze rolls to remove all excess glycerin. Finally, the glycerin-treated parchment is dried. As will be understood, the percentage of glycerin in the paper is not critical, and may be varied and adjusted to give the sheet any desired hygroscopicity.

In making the surgical sheet, the above described outer layer is applied to a second sheet of paper which ordinarily will be substantially heavier and thicker than the outer layer, and characterized by its capacity for retaining fluids that may pass through the giycermized outer layer. This moisture-retaining paper, to which I refer as the inner layer, may or may not be moisture absorptive, although in either single or multiple layers, it will resist penetration by fluids sufficiently to prevent moisture from passing through. This inner layermay consist ofa suitable creped parchment paper which, as compared with the outer layer, may have a relatively fibrous structure. This creped parchment is of a common form, made by rolling the pulp ilbers` into sheet form, parchmentizing the sheet, and finally creping it. The creped paper, however, .is relatively stiff and may be somewhat noisy when handled in the operating room. The outer layer, being soft and pliable, acts effectively to;

dampen and eliminate any undesirable noisy characteristics of the creped parchment. As will be understood, the latter may be made to have some, or even a substantial degree, of moisture absorptiveness, or it may virtually be moistureorganisms, upon open exposure of the sheets and during an operation, despite the fact that the sheets initially may have been perfectly sterilized. In accordance with the invention I have produced a surface layer sheet that has the desired moisture Vretentiveness .and permeability, and at the same time a closed formation presenting a continuous surface without appreciable open porosity that precludes any possibility of germs being retained within the sheet in the manner lof cloth or any other porous material.l

The above mentioned features and objects of the invention will perhaps be more vclearly understood and explained to best advantage from the following description of certain sheet materials typifying the invention. In the description, reference is had to the accompanying drawing in which:

Fig. 1 shows a fragmentary portion of sheet material comprising a single layer of crepe parchment paper between two outer layers of the relatively soft glycerinized parchment;

Fig. 2 shows a similar sheet including two layers of the crepe parchment to increase the imperviousness of the sheet to moisture; andv Fig. 3 shows a sheet material particularly suitable for surgical garments and comprising single sheets of both the crepe and smooth finish parchment papers.

In the drawing, I have shown only fragmentary portions of these typical sheet materials, with the understanding that they may be used for fabricating the various articles such as surgical garments, pads, drapes, etc., going to make up a complete operating outfit. Accordingly, it will be unnecessary to illustrate the individual articles themselves fully and in detail. K Referring now to Fig. l, the composite sheet III is shown to be made up of outer layers Il and l2 of the relatively smooth and soft gelatinized parchment paper, and an intermediate layer I3 of the relatively stiff creped parchment paper. 'Ihese several sheets may be joined to- I sheet by liquids, it is only necessary to increase gether in any suitable manner so as to form .in effect a single sheet, as for example by folding over the edges I4 and sewing them as indicated at I5 but leaving adjacent surfaces of the layers unattached over the greater area of the sheetso that liquid may pass through the thin outer layer into the space between the layers.

The type of sheet shown in Fig. 1 and embodying a single intermediate layer` of the creped parchment, may be used, for example, in the making of drapes which may be subjected to a certain amount of moisture, but not to the extent of pads which are apt to be subjected to considerable more wetting. By reason of the hygroscopic character of the glycerinized outer layers Il and I2, the paper of these layers tends to readily hold or absorb liquids deposited on them, and thus prevent the liquids from flowing o readily, as they would from a non-hygroscopic and waterproofed surface. The liquid penetrates the outer layer and is largely absorbed or at least retained by the intermediate creped parchment I3 which thus serves to hold the liquid in -the sheet. As previously indicated, in being made of parchmentized paper, none of the layers, while moisture absorptive, tends to disintegrate when permeated by liquids.

In order to increase the impermeability of the the number of the creped parchment layers. Thus in Fig. 2 the sheet I6 is shown to be composed of two layers I1 of thev crepe parchment paper between outer layers I8 and I9 of the softer parchment. The number of layers I1 may of course be increased to enhance the absorptive capacity and imperviousness of 'the sheet, de-

pending upon the particular purpose for which it is to be used.

For some purposes, as for example surgical garments, it may not be necessary to include both of the outer layers referred to in Figs. 1 and 2. Thus as illustrated in Fig. 3, the sheet may be made of a single outer layer 20 of the soft parchment paper, and a. single inner layer 2l of the creped parchment.

Instead of making the inner layer, for example layer I3 in Fig. 1, of a parchment paper, I may use any other suitable paper possessed in general of the aforementioned properties of creped parchment, particularly its iiuid impermeability. For example, I may use an ordinary substantially white paper, creped or not, coated with a suitable moisture prooiing substance to give the layer the desired impermeability. As will be apparent, the outer soft and pliable glycerinized paper will have essentially the same advantages in combi-v nation with the non-parchment layer as with the creped parchment.

I'have previously mentioned that the present type of appliances are advantageously adapted to being dispensed in sterilized condition within hermetically sealed packs. Thus a complete set of articles required for use in an operation may be placed one upon the other, folded into a com- I pact roll and placed in a container, such as a can, within which the pack is completely sterilized and the container then hermetically sealed. In this form the packs may be distributed to hospitals,.drug stores, or kept on hand by surgeons, so as to be readily available for use when required. The present sheet material is especially suitable for making the various articles to be dispensed in this manner, that is in sterilized packs comprising a complete surgical outfit hermetically sealed in containers, because of the small bulk of the pack as compared with the bulk of a pack ,containing a corresponding number of cloth articles. The usual cloth packs are in fact so large and bulky as to make it impractical to handle them in sealed containers, whereas the present pack may easily be rolled into such a compact package as to require only a very small container.

I claim:

1. A surgical sheet of the character described, comprising a thin layer of smooth, flexible paper that has no appreciable open porosity and which is hygroscopic and pervious to moisture without disintegration, and a layer of a relatively stii and less moisture pervious paper applied to the rst mentioned layer, and means joining said layers together but leaving their adjacent sur; faces unattached over the greater portion of the sheet area.

2. A surgical sheet of the character described, comprising a layer of thin, smooth surface iiexible paper that has no appreciable open porosity andwhich is hygroscopic and pervious to moisture without disintegration, and a layer of relatively stif and less moisture pervious creped paper applied to the rst mentioned layer, said layers being secured together at their edges, leaving their -adjacent surfaces unattached over the greater portion of the sheet area, and the rst mentioned layer serving to dampen the sound of said creped paper as the sheet is exed.

3. A surgical sheet of the character described, comprising a thin layer of smooth, exible paper thathas no appreciable open porosity and which is hygroscopic and pervious to moisture without disintegration, and a layer of substantially moisture proof paper applied to the rst mentioned layer, said layers being folded and secured together at their edges.

4. A surgical sheet of the character described, comprising outside layers of glycerinized parchment paper that is relatively soft and pliable and pervious to moisture, a layer of relatively stii creped parchment paper between the first mentioned layers, ard means joining said layers together at their edges but leaving their adjacent surfaces unattached over the greater portion of the sheet area.

5. A surgical sheet of the character described.

comprising a layer of glycerinized parchment paper that is relatively soft and pliable and pervious to moisture, a layer of relatively stiif creped parchment paper applied to the rst mentioned layer, and means joining said layers together'at their edges but leaving their adjacent surfaces unattached over the greater portion of the sheet area.

6. A surgical sheet of the character described, comprising a layer of glycerinized parchment paper that is relatively soft and pliable and pervious to moisture, a layer of relatively stiff parchment paper applied to the rst mentioned layer, and means joining said layers together at their edges but leaving their adjacent surfaces unattached over the greater portion of the sheet area.

7. A surgical sheet of the character described comprising a layer of thin glycerinized parchment paper that is relatively soft and pliable and pervious to moisture, and a layer of relatively stiff and fibrous parchment paper applied to the rst mentioned layer, and means joining said layers together at their edges but vleaving their adjacent surfaces unattached over the greater portion of the sheet area. l

8. A surgical sheet of the'character described comprising a layer of paper that is relatively heavy and substantially impervious to liquids, a second layer of relatively thin, smooth surface paper applied to the rst mentioned layer, said second layer having no appreciable open porosity and means for securing said layers together at their edges, said second layer being readily re tentive of moisture and permeable by liquids without di'sintegrating,I and also being very pliable so as to dampen the sound of said relatively heavy layer as the sheet is exed.

9. A surgical sheet of the character described comprising a layer of thin glycerinizedV parchment paper that is relatively soft and pliable and pervious to moisture, a layer of relatively stii less-moisture-pervious paper applied to the flrstmentioned layer, and means Joining said layers together at their edges but leaving their adjacent surfaces unattached over the greater portion of the sheet area.

EDWARD F. BRUNING. 

